Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2025
Lumbar total disc replacement versus anterior and transforaminal lumbar interbody fusion: a systematic review and meta-analysis of clinical and radiological outcomes.
СтатьяСистематический обзорМетаанализСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Khan Sabir, Naseem Ayesha, Khan Bilal Wazir, Saif Hammad, Khattak Muhammad Huzaifa, Muneeb Muhammad, Khan Farwa, Haq Izhar Ul, Khattak Savira
Аннотация
OBJECTIVE: This meta-analysis aims to compare the perioperative results, safety, and efficacy of the Lumbar Total disc replacement (LDR) to Anterior Lumbar interbody fusion (ALIF) and Transforaminal lumbar interbody fusion (TLIF).
METHODS: PubMed, Embase, Cochrane, and clinicaltrials.gov databases were systematically searched from inception until August 2025. Outcomes reported include surgical outcomes[operative time, length of hospital stay, estimated blood loss, reoperation rate, removal rate], clinical outcomes [NRS score for back pain, ODI, time required to return to work after surgery, adverse events, overall success], and radiological outcomes [in terms of range of motion]. Review Manager 5.4. was used for statistical calculations, with a p-value of < 0.05 indicating statistical significance.
RESULTS: This meta-analysis included five observational studies and 5 RCTs, with a total of 2103 patients (1294 in the LDR group and 809 in the IBF group). LDR was associated with a 74 % higher risk of removal rate compared to IBF [RR: 1.74, P = 0.0009]. Similarly, LDR was associated with statistically significant improvement in range of motion [ROM] compared to IBF [MD:9.04, P < 0.00001]. However, No statistically significant difference was found between LDR and IDF group in terms of operative time [MD: -12.91,p = 0.34], estimated blood loss [MD: 0.10, P = 1.00], adverse events [RR:0.99, P = 0.97], reoperation rate [RR: 0.67, P = 0.63), Oswestry disability index (ODI) success [MD: -8.13, P = 0.15], length of hospital stay [MD:-0.23, P = 0.14], reduction of back pain [MD: -8.13, P = 0.15], and overall success [RR = 1.14, P = 0.75].
CONCLUSION: For Degenerative disk disease, LDR and IBF offered similar clinical results. However, LDR exhibits benefit in terms of improvement in range of motion, while IBF exhibits benefit in terms of having a lower risk of removal rate.
METHODS: PubMed, Embase, Cochrane, and clinicaltrials.gov databases were systematically searched from inception until August 2025. Outcomes reported include surgical outcomes[operative time, length of hospital stay, estimated blood loss, reoperation rate, removal rate], clinical outcomes [NRS score for back pain, ODI, time required to return to work after surgery, adverse events, overall success], and radiological outcomes [in terms of range of motion]. Review Manager 5.4. was used for statistical calculations, with a p-value of < 0.05 indicating statistical significance.
RESULTS: This meta-analysis included five observational studies and 5 RCTs, with a total of 2103 patients (1294 in the LDR group and 809 in the IBF group). LDR was associated with a 74 % higher risk of removal rate compared to IBF [RR: 1.74, P = 0.0009]. Similarly, LDR was associated with statistically significant improvement in range of motion [ROM] compared to IBF [MD:9.04, P < 0.00001]. However, No statistically significant difference was found between LDR and IDF group in terms of operative time [MD: -12.91,p = 0.34], estimated blood loss [MD: 0.10, P = 1.00], adverse events [RR:0.99, P = 0.97], reoperation rate [RR: 0.67, P = 0.63), Oswestry disability index (ODI) success [MD: -8.13, P = 0.15], length of hospital stay [MD:-0.23, P = 0.14], reduction of back pain [MD: -8.13, P = 0.15], and overall success [RR = 1.14, P = 0.75].
CONCLUSION: For Degenerative disk disease, LDR and IBF offered similar clinical results. However, LDR exhibits benefit in terms of improvement in range of motion, while IBF exhibits benefit in terms of having a lower risk of removal rate.